Are patient satisfaction surveys tools for quality improvement or mere symbolism? : The case of Østfold Hospital Trust in Norway

Abstract: In 1997 and 2002 the Østfold Hospital Trust conducted patient satisfaction surveys. This study presented the results of the 2002 survey and compares them with the 1997 results. This is done to ascertain if there are any changes with regards to the dimensions the hospital scored poorly on in 1997. The purpose of this study is to find out if the patient satisfaction survey conducted at the Østfold Hospital Trust in 1997 was a serious attempt to improve the quality of the health care provided or only a symbolic act. The concepts of innovation, rational choice and institutional theory were used as spectacles to analyse how the Østfold Hospital Trust acted on the results of the 1997 patient satisfaction survey. The choice of study design is not an "either / or" situation between the quantitative and qualitative approach, since both methods can strengthen each other. This study has therefore employed a form of methodological triangulation. The finding of the study showed that the Østfold Hospital Trust can be termed as innovative, when they implemented the patient satisfaction survey in 1997. This because there was no coercive forces from the hospital owners to implement such surveys. There were only signals in the form of strategy documents. In spite of the hospitals innovative action in implementing the non-mandatory survey in 1997, the hospital leadership did not use the results to improve quality. Based on the findings, the study can conclude that the implementation of the patient satisfaction survey in 1997 was more symbolic, rather than a quality improvement act. Looking further than 1997, it’s important to remark that the hospital leadership resolved a number measures to improve quality, based on the 2002 patient survey. At the time of writing the issue of patient feedback as a quality improvement tool is high on the agenda at the Østfold Hospital Trust. The development point in the direction of a paradigm shift